Papers by Tiffany Ting-Fang Shih
Magnetic Resonance Imaging, 2016
Objective: To compare a multiple breath-hold, multiecho, multiplanar spin-echo (BHMEMPSE) magneti... more Objective: To compare a multiple breath-hold, multiecho, multiplanar spin-echo (BHMEMPSE) magnetic resonance (MR) sequence with a TR of 300 ms with a traditional multiecho, multiplanar spin-echo (MEMPSE) MR sequence for assessing liver iron content. Materials and Methods: This study was approved by the institutional review board; informed consent was waived. Liver R2 measurement was derived from the mono-exponential model by BHMEMPSE and MEMPSE MR sequences of a 1.5T MR machine in 30 thalassemia patients (9 men, 21 women, aged 27.7 + 6.8 years). Hepatic iron contents were estimated using Ferriscan in all patients. The inter-and intra-observer agreement of the 2 MR sequences was also evaluated. Results: MEMPSE R2 values significantly correlated with Ferriscan iron content values (r = 0.895, p < 0.001) and serum ferritin concentration (r = 0.661, p < 0.001). BHMEMPSE R2 values significantly correlated with Ferriscan values (r = 0.914, p < 0.001) and serum ferritin concentration (r = 0.608, p < 0.001). The distribution of MEMPSE R2 values against BHMEMPSE R2 values revealed an excellent linear relationship (r = 0.978, p < 0.001). The inter-and intra-observer agreement of the 2 MR sequences was excellent, with an interclass correlation coefficient exceeding 0.9.
Diagnostics
Objective: This study assessed dynamic contrast-enhanced (DCE)-MRI and intravoxel incoherent moti... more Objective: This study assessed dynamic contrast-enhanced (DCE)-MRI and intravoxel incoherent motion diffusion-weighted imaging (IVIM DWI) parameters to prospectively predict survival outcomes in participants with advanced hepatocellular carcinoma (HCC) who received lenalidomide, a dual antiangiogenic and immunomodulatory agent, as second-line therapy in a Phase II clinical trial. Materials and methods: Forty-four participants with advanced HCC who had progression after sorafenib as first-line treatment were prospectively enrolled. Pretreatment MRI parameters—obtained from DCE-MRI (peak, slope, AUC, Ktrans, Kep, and Ve), apparent diffusion coefficient (ADC), and IVIM DWI (pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f))—were derived from the largest hepatic tumor. The Cox model was used to investigate the associations of the parameters with progression-free survival (PFS) and overall survival (OS). Results: Median PFS and OS were 2.3 and 8...
Frontiers in Bioengineering and Biotechnology, 2021
Background: Lumbar disc herniation (LDH) is among the most common causes of lower back pain and s... more Background: Lumbar disc herniation (LDH) is among the most common causes of lower back pain and sciatica. The causes of LDH have not been fully elucidated but most likely involve a complex combination of mechanical and biological processes. Magnetic resonance imaging (MRI) is a tool most frequently used for LDH because it can show abnormal soft tissue areas around the spine. Deep learning models may be trained to recognize images with high speed and accuracy to diagnose LDH. Although the deep learning model requires huge numbers of image datasets to train and establish the best model, this study processed enhanced medical image features for training the small-scale deep learning dataset.Methods: We propose automatic detection to assist the initial LDH exam for lower back pain. The subjects were between 20 and 65 years old with at least 6 months of work experience. The deep learning method employed the YOLOv3 model to train and detect small object changes such as LDH on MRI. The data...
Cancers, 2021
In this paper, our main objective was to predict survival outcomes using DCE-MRI biomarkers in pa... more In this paper, our main objective was to predict survival outcomes using DCE-MRI biomarkers in patients with advanced hepatocellular carcinoma (HCC) after progression from 1st-line sorafenib treatment in two prospective phase II trials. This study included 74 participants (men/women = 64/10, mean age 60 ± 11.8 years) with advanced HCC who received 2nd-line targeted therapy (n = 41 with lenalidomide in one clinical trial; n = 33 with axitinib in another clinical trial) after sorafenib failure from two prospective phase II studies. Among them, all patients underwent DCE-MRI at baseline, and on days 3 and 14 of treatment. The relative changes (Δ) in the DCE-MRI parameters, including ΔPeak, ΔAUC, and ΔKtrans, were derived from the largest hepatic tumor. The treatment response was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST 1.1). The Cox model was used to investigate the associations of the clinical variables and DCE-MRI biomarkers with progression-free survi...
Journal of Cancer Research and Practice, 2016
Bone marrow angiogenesis can be measured by DCE-MRI. DCE-MRI is an imaging technique that appears... more Bone marrow angiogenesis can be measured by DCE-MRI. DCE-MRI is an imaging technique that appears to provide quantitative and biologically relevant information related to tumor vasculature and angiogenesis, which can inform novel drug efficacy, monitor treatment response and act as an imaging biomarker to predict treatment outcome and survival in hematological malignant patients. Increased bone marrow perfusion as reflected by higher Peak value can independently predict adverse clinical outcome in patients with acute myeloid leukemia (AML). In addition, DCE-MRI derived data of bone marrow in AML patients at remission status provides useful information on clinical outcome of patients who might have relapse or not. Patients with a higher value for Kep at remission status would have shorter relapse-free duration and may need to undergo additional therapy. In multiple myeloma, DCE-MRI data correlate strongly with marrow tissue microvessel density. Studies identify high Amplitude values as a possible risk factor associated with the development of extra-medullary disease in multiple myeloma patients; these findings partly support the hypothesis that bone marrow angiogenesis may play role in the development of extra-medullary disease in multiple myeloma. DCE-MRI derived-parameters could serve as a guidance for the selection of optimal management plans, thereby contributing to the development of "personalized medicine" for patient.
Physical therapy, 2014
Lumbar disk degeneration (LDD) has been related to heavy physical loading. However, the quantific... more Lumbar disk degeneration (LDD) has been related to heavy physical loading. However, the quantification of the exposure has been controversial, and the dose-response relationship with the LDD has not been established. The purpose of this study was to investigate the dose-response relationship between lifetime cumulative lifting load and LDD. This was a cross-sectional study. Every participant received assessments with a questionnaire, magnetic resonance imaging (MRI) of the lumbar spine, and estimation of lumbar disk compression load. The MRI assessments included assessment of disk dehydration, annulus tear, disk height narrowing, bulging, protrusion, extrusion, sequestration, degenerative and spondylolytic spondylolisthesis, foramina narrowing, and nerve root compression on each lumbar disk level. The compression load was predicted using a biomechanical software system. A total of 553 participants were recruited in this study and categorized into tertiles by cumulative lifting load ...
Metabolic Syndrome and Related Disorders, May 20, 2022
Metabolic Syndrome and Related Disorders, 2021
Background: This study aimed to measure and compare (1) the microcirculation and microcirculatory... more Background: This study aimed to measure and compare (1) the microcirculation and microcirculatory responses of the muscles and tendons at rest and during isometric muscle contractions in participants with and without diabetes mellitus (DM) and (2) to determine correlations between microcirculation and muscle strength. Methods: Sixty-three participants with type 2 DM and 42 physically matched controls were recruited. Baseline measurements of the microcirculation of the rectus femoris (RF) and medial gastrocnemius (MG) muscles and patellar (PT) and Achilles tendons (AT), as well as their microcirculatory changes during maximal isometric exercises, were performed and recorded by using near-infrared spectroscopy and a red laser. Data on various laboratory tests (including glycated hemoglobin, triglyceride, high-density cholesterol), the monofilament test, and the ankle-brachial index were also obtained. Results: The baseline measurements indicated that, compared with the controls, the diabetic participants had lower oxygen saturation (SpO2) in their RF and MG muscles (both P < 0.001), and the total hemoglobin in the diabetic PT and AT was higher (P = 0.001 and P = 0.01). The minimal SpO2 levels in the aforementioned muscles during isometric contractions were lower in the diabetes group than in the control group (P ≤ 0.001). Furthermore, there were correlations between the microcirculatory change of the RF muscle and the knee extension force. Conclusions: This study demonstrated the effects of diabetes on the microcirculation of skeletal muscles and tendons during baseline measurements and responses to maximal isometric exercises. The results support the need for preventive strategies for diabetic muscles to prevent adverse complications when performing resistance training.
Muscle Ligaments and Tendons Journal, 2020
Background. This study sought to compare the ultrasound tissue characteristics of the muscles (in... more Background. This study sought to compare the ultrasound tissue characteristics of the muscles (including muscle thickness, echo intensity, and stiffness) and tendons (including thickness, stiffness, and peak spatial frequency radius (PSFR)) of participants with or without diabetes mellitus. Moreover, the study sought to determine any relationships between the muscle stiffness and strength or tendon PSFR and the results of blood tests, including the glycation or lipid profiles, of the diabetics. Methods. Twenty-three participants with type 2 diabetes mellitus and nineteen controls without a history of diabetes were recruited. Results. The diabetic muscles exhibited less thickness (P=0.024), greater echo intensity (P=0.033 and 0.002), and lower muscle stiffness (P=0.015 and 0.009) than the control muscles. Furthermore, the diabetic tendons exhibited a lower PSFR (P ranged between 0.037 and <0.001). There were correlations between the resting stiffness of the gastrocnemius muscle and the height of heel lifting (r=0.450, P=0.031), between the PSFR in the patellar tendon and the hemoglobin A1c level (r=-0.539, P=0.017), and between the PSFR in the Achilles tendon and the high-density lipoprotein cholesterol level (r=0.545, P=0.019). Conclusions. The diabetic muscles and tendons exhibited morphomechanical changes associated with force capacity or markers of insulin resistance. Clinical applications of musculoskeletal ultrasound techniques to diabetics include using them to design exercise strategies and for microstructural screening.
Magnetic resonance imaging, Jan 19, 2015
To investigate the water and lipid composition of normal women breasts on proton MR spectroscopy ... more To investigate the water and lipid composition of normal women breasts on proton MR spectroscopy ((1)H-MRS), and the association of breast cancer risk factors with (1)H-MRS parameters. Three groups of participants were included: group 1, women without a family history of breast cancer (n=49); group 2, women with at least one affected first-degree relative (n=77); group 3, contralateral normal breasts of women with newly diagnosed unilateral breast cancer (n=84). (1)H-MRS parameters were shown below: water fraction 1 (WF1)=(water integral)/(water integral+integral for methylene peak); lipid line width for methylene resonance (LW1) and lipid line width for methyl peaks (LW2) were measured. The association of breast cancer risk factors - age, breast density, body mass index (BMI), menopausal status, group with (1)H-MRS parameters - was analyzed by multiple linear regression. In age-adjusted multiple linear regression, breast density was positively associated with WF1 (P=0.009, 0.001, a...
Cervical myelopathy had been noted in patients with involuntary neck movement, especially in indi... more Cervical myelopathy had been noted in patients with involuntary neck movement, especially in individuals with athetoid-dystonic cerebral palsy(CP). The excessive and repeated neck motions were considered to be responsible for the premature spondylosis, which might be the cause of myelopathy. The exact pathophysiology and managements were still controversial. Here we present a rare case who was a male patient with long-lasting dystonic neck movement developing cervical myelopathy due to protrusion of disc in his relatively young age. Magnetic resonance imaging (MRI) showed the protrusion of cervical disc at the level of C3-4, which was correlated well with his clinical symptoms. Anterior diskectomy and bony fusion were done for decompression. Halo-vest immobilization was applied to prevent the instability coming from dystonic neck movement after surgery. There was partial neurologic recovery after surgery. It is a rare clinical condition and may be easily overlooked. Therefore we rec...
Polymers, 2021
Here, we aimed to investigate the safety and preliminary efficacy of Kartigen®, a matrix with aut... more Here, we aimed to investigate the safety and preliminary efficacy of Kartigen®, a matrix with autologous bone marrow mesenchymal stem cell-derived chondrocyte precursors embedded in atelocollagen. As a surgical graft, Kartigen® was implanted onto the cartilage defects at the weight-bearing site of the medial femoral condyle of the knee. Fifteen patients were enrolled and stratified into two groups, undergoing either Kartigen® implantation (n = 10) or microfracture (control group, n = 5). The primary endpoint was to evaluate the safety of Kartigen® by monitoring the occurrence of adverse events through physician queries, physical examinations, laboratory tests, and radiological analyses for 2 years. There were no infections, inflammations, adhesions, loose body, or tumor formations in the Kartigen®-implanted knees. The preliminary efficacy was assessed using the International Knee Documentation Committee (IKDC) score, visual analog scale, and second-look arthroscopy. The postoperativ...
Lighting Research & Technology, 2016
A half-bridge circuit topology for driving high-intensity discharge lamps at high frequencies is ... more A half-bridge circuit topology for driving high-intensity discharge lamps at high frequencies is proposed. The high-frequency square wave is modulated synchronously by low-frequency, sawtooth signals. Under such circumstances, the phenomenon of acoustic resonance can be successfully prevented because standing waves within the wall of the lamp are eliminated. This has been experimentally verified. Results obtained will offer useful information for designing high-efficiency high-intensity discharge lamps.
The virtual mentor : VM, 2011
The virtual mentor : VM, 2011
Proceedings of the National Academy of Sciences of the United States of America, 2014
It is generally accepted that healthy cells degrade their own mitochondria. Here, we report that ... more It is generally accepted that healthy cells degrade their own mitochondria. Here, we report that retinal ganglion cell axons of WT mice shed mitochondria at the optic nerve head (ONH), and that these mitochondria are internalized and degraded by adjacent astrocytes. EM demonstrates that mitochondria are shed through formation of large protrusions that originate from otherwise healthy axons. A virally introduced tandem fluorophore protein reporter of acidified mitochondria reveals that acidified axonal mitochondria originating from the retinal ganglion cell are associated with lysosomes within columns of astrocytes in the ONH. According to this reporter, a greater proportion of retinal ganglion cell mitochondria are degraded at the ONH than in the ganglion cell soma. Consistently, analyses of degrading DNA reveal extensive mtDNA degradation within the optic nerve astrocytes, some of which comes from retinal ganglion cell axons. Together, these results demonstrate that surprisingly la...
Muscle, 2012
Receptor tyrosine kinases (RTKs), the largest, identified family of enzyme-linked receptors, have... more Receptor tyrosine kinases (RTKs), the largest, identified family of enzyme-linked receptors, have been the subject of intensive research for their role in normal cellular function and disease pathogenesis. RTK signal transduction pathways map a wide spectrum of functions, including regulation of cellular proliferation and differentiation, promotion of cell survival, and modulation of cellular metabolism. They have been characterized in a number of disease processes, including diabetes, cancer, and cardiovascular diseases. This chapter reviews the biological role of RTKs, the types and subfamilies, and the mechanisms of RTK signaling and its downstream effects. RTK expression and function in cardiac muscle is described in a comprehensive review of the specific subfamilies that play integral roles in cardiac muscle development and embryogenesis as well as adult cardiac dysfunction, hypertrophy and repair. Lastly, we describe GPCR-mediated RTK transactivation as an important regulatory mechanism of RTKs in cardiac muscle.
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Papers by Tiffany Ting-Fang Shih